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Tuesday, February 12, 2013

Guest post: End of residency rant

One short, miniscule, month. And I can’t
get my shit together.

I started medical school almost eight years
ago. I had the world at my feet. I was married five weeks before med school
started. My husband was in graduate school about an hour away. I had a
wonderful social life, and the resume-padding was unbelievable.

Then, unexpectedly, just before the end of
my first year, I was pregnant.

Now, I am blessed with three beautiful
children, the same wonderful husband, a dog, and a cat. I am about to start an
exciting, rewarding career. I have a loving family and, once we dig out from
under the mortgage-sized debt of my medical training, the prospect of a secure
financial future. My licensing exam is completed – and passed. My application
for independent practice is submitted.

Tick, tick, tick goes the checklist.

So why am I so blue?

Because I am sitting in my “office”, in the
basement, for the gazillionth time, while my husband puts the children to bed.
I am supposed to be finishing my resident research project, but all I can think
about is the sacrifice that went into this whole deal. And I feel like I just
can’t do it one more time. I can’t sit down here, while my kids do their thing,
while my husband cooks and wipes little faces and hands, and dresses and
changes, and talks and explains and answers little questions, while he washes
hair and towels dry and finds pajamas, while he surfs the net in lieu of my
company and attention. I spent months studying for my exam down here. I still spend
endless hours down here administering to administration, to licensing bodies
and colleges and universities and evaluations and preceptors and the endless
litany of mindless work that only I can do. And I just can’t do it anymore. I
am utterly spent.

Where are the other medical mothers who
feel this way? Is acknowledging this darkness akin to yielding to it? Because I
have noticed that no physician who does creative writing in popular medical journals
seems to get published unless there is a vein of hope, silver lining, outwardly
optimistic, or putridly glowing endorsement of the profession tucked into the
moral of the story. We only want to hear tales of physician woe if the tales
end with the message that we are the fortunate, rarefied few who get to
struggle in this way. We hold our noble heads high.

Give me a break. Give me the sweaty mothers
who can’t afford a nanny or a housekeeper or even a babysitter for a night out.
Give me the stressed out mothers with messy homes and offices and cluttered
minds and hearts. Give me the medical mothers who nurse their infants while
reading their journals, then feel guilty about splitting their attention. I
want to befriend the other mothers who adore their children so much that their
hearts break on a daily basis – yet can’t stand the same children disturbing their
few hours of consecutive sleep. Give me the doctors who love medicine, who want
to see patients all day and night, who listen to medical podcasts and fantasize
about intubating crashing patients while doing their completely irregular
workouts (it does get the heart rate up), who obsess over the evidence basis for
PSA testing and feel crushed when they miss a diagnosis. I want to be friends
with dedicated mothers and dedicated doctors, and I want to acknowledge the
horror of combining those two wonderful people into one. Because it isn’t as
pretty as it sounds.

So, as I sit down here, I just can’t get my
shit together. I can’t decide if it’s all been worth it or not. On the very
cusp of being “done” with training, with one foot raised and about to touch the
start line of the rest of my life, I can’t decide. Or maybe, I’m a little bit
sickened. Because maybe, I want to admit, that the sacrifice has been too
great, and if I could do it all over again, maybe I just wouldn’t. Silver
lining be damned. I’ve always wanted to be a mother, more than I ever, ever
wanted to be a doctor. And while being a mother has undoubtedly made me a much
better doctor, I cannot say that the reverse is true. In fact, being a doctor
has stolen gaping wounds of time and attention from my mothering soul.

But I can’t bring myself to say it just
yet. Somehow, despite the sickness in my heart, I just can’t say it. Perhaps
the future knows something I don’t. Perhaps I just can’t bear to close a piece
of writing on a negative note.Maybe I
am copping out, playing to the audience, telling you what I think you want to
hear. I don’t know. So I sit in my basement office a little longer, the
children are asleep, and soon I should be, too. Because tomorrow the children
will want me, it will be my 27th-last day of residency, and there is still,
always, work to be done.

15 comments:

oh no! but thank you for sharing. i am 32 days away from finding out where I match for residency and just found out i'm pregnant! i don't know whether to laugh or cry.... but thank you for keeping it real. i hope for your sake (and mine) that the future will make you glad you did both. but you are allowed to have moments of doubt. again, thank you for this post. that is what MIM is all about, no?

Thank you for your rant. I am a first year resident with two children born in Medical School. I would have a hard time making this career choice if given the chance again. I know nothing about the sacrifices of being a mom who has more time with her children and forgoes career and aspiration. I know only about the sacrifices that you mention above, and they are heavy and raw at times. I have times of doubt but always come to the same conclusion, the only way out is through. And like you, I love my work but not not as much as my kids... I cling to hope, because the alternative is paralyzing.

In my experience, there is often a period of let down/minor depression that happens after a goal has been achieved, especially goals that were hard fought and took a lot of sacrifice. I'm not a physician yet but I'm a mother who prioritized her children & family over career for many years. I value the time I spent working part-time and in flexible FT jobs when my kids were young, but now that they are older, I am comparing my relationship with my children with those of women who had more hard driving careers and I don't see a very big difference. And I have no small amount of regret over the way that my desires, drive and ambitions took a back seat for so many years. I'm 40 and about to start medical school. There is no one path to a happy work-life balance and we spend more time striving for it than achieving and enjoying it. I hope that this moment passes for you and that you find joy in your life's choices. You have tremendous opportunities in front of you, professionally and personally. May you find a way to enjoy them!

I really hope you get some time off between residency and starting your job. Remember, its your choice from here on out---med school & residency is mostly out of your hands, but you can now choose what kind of job fits best for you & your family. And if it doesn't work out the first time, don't be afraid to keep looking. Best of luck to you, you sound like an amazing & dedicated doctor & mother.

Thank you to each of you for your response. It means a lot to me that you took the time to comment. SIQ - congrats on your pregnancy! That is wonderful news. Do not let my doubts contaminate your joy - having a baby is amazing. I am very happy for you! NM - thank you, thank you, thank you for the empathy. Sometimes I feel like the only person out there who could possibly feel this way (followed by - "what is wrong with me?"). That was partly why I posted - to see, if I was truly alone. And I wholly agree with you - the only way out is through. Good luck with the rest of your residency, and have faith - it does end. Larissa, your perspective is much appreciated, especially the part about your relationship with your children being similar to your friends' with more hard driving careers. I know that I am not, and never will be, a SAHM, but I also know that I do everything I can to maintain a close bond with my kiddos. I hope that you love medical school. Ana - I will be sure to be fitting my job into my life, and not the other way around. Finally. Thank you for your comments.Yes, I am at a low point, but that is why I love MiM. Thanks for being here, ladies.

Really sorry to hear you're so blue. I don't have a silver lining to offer, only empathy and cheerleading. Empathy: today is my second day back to residency after a month-long personal leave. The month was in lieu of me quitting residency because the juggling act of motherhood/resident/wife to surgery resident was out of control. I, too, have a glorious basement office which makes me naush/vom whenver I have to go down there and study for boards/ITE/lit search/whatever. I feel like it's a metaphor for my life, sitting in the cold dank, alone, with only spiders for friends. And then I hear the wahmbulance playing the world's smallest violin and remember that I'm choosing to be down there and have been given a beautiful opportunity to be involved in medicine. Cheerleading: you can do it! You're SOCLOSE! Don't think about it so much. Just take a small bite today and don't think about the rest of the elephant that's left to eat. Don't think about what it's taken for you to get to this point. Just keep going. Many of the wonderful women I've met, including my program director, is a great supporter of moms in medicine and she always tells me how many OPTIONS we'll have once done with residency, we can choose whatever kind of job best suits our and our family's needs.

The world is STILL at your feet (are yours bigger after kids? Mine are). I'm rooting for you.

Yes, they are an entire size bigger!I'm glad you took the month off. It sounds like a very wise choice.I'll think of you when I'm hanging out with my basement spiders.Thanks for the support! I'm rooting for you, too.

MH - what a fantastic post. I can, and will, offer a silver lining. Life is much more wonderful as a physician and mother when you are in control of it. It took me a while to figure this out - but I am finally in a place where I am truly happy, love what I do, and my children, although lamenting sometimes that I am not a SAHM, are proud of me.

End of residency can be truly depressing - it was for me for sure. I was worn out, way too damn skinny, overworked as hell, but I had some nice strong defenses convincing myself that my life was great even when it wasn't. I look back and laugh at that. Now as a partner in private practice, sure I have rough days (14 frozens this afternoon on top of two hour meeting and too much work!). But it's so much more fun to tackle when you have a personal stake in it and you are in control of the madness. And I am off for the next 5 days to revel in kid Valentine parties and take my kids to a Winter Break trip to visit some mentors and kids at fancy academic institution.

Life is better when you are in control and rewarded for your efforts. Hold out for that. Sure, the ultimate goal, as was when you embarked on this, is taking care of patients. That's still there, and even better when you are happy.

It wasn't a basement for me - it was a flashlight in a closet before the crack of dawn. In between nursing and pumping. I felt so alone. I've been there. Not to beat a dead horse, but it gets better. I have been accused of being a Pollyanna. But I live my life for me now, not for someone else. I can empathize with wanting to wallow in reality, not tidy happy endings. Still do, sometimes. But overall life is amazing.

Sleeeeeeeep is restorative. You are not alone. It is worth the intensities of the highs and lows, because you are a dedicated physician and mother and spouse. Even if you need to split your attention or do some things well some of the time and other things well at other times. I hope you can come up out of the basement and feel some vitamin D rich sunshine.

I think when you read those tales of woe that have a silver lining, what is included is an element of some reflection; the person writing (publishing in those medical journals you mentioned) is reflecting back on the experience and then learning from it in order to embrace the future.

Did I mention, sleep can be restorative! Thanks for posting. Keep pondering. Wishing you well.

Well, here is another mother in medicine who has felt as you are feeling. I am in my first year post residency, about to go into fellowship, and still struggling to be a decent mother and doctor at the same time. I too feel that being a mother makes me a better doctor but I am not so sure about vice versa. I think that in the thick of raising children it is easy to question our competence as mothers, but I am hanging my hat on our family looking back 30 years from now and being grateful for the role model I provided as well as the opportunities I was able to give my children as a result of being a physician. I agree that control of your schedule and sleep will do wonders for your outlook, I have had the joy of those things this year, and while it doesn't solve everything, it is so much better. Hang in there.

Thank you for writing the truth and not sugar coating it. I just had my 2nd child. Not in med school yet but will be in 3 yrs, looking forward to it and preparing myself by coming here everyday sharing all your thoughts and hard work. Good job to you and you are almost there!!!! You will have alot of time with your kids!!!

Mothers in Medicine is a group blog by physician-mothers, writing about the unique challenges and joys of tending to two distinct patient populations, both of whom can be quite demanding. We are on call every. single. day.

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